—  SPECIALTY CONFERENCE  — Surgical Pathology Monday, March 19, 2012, 7:30 PM Convention Centre Ballroom A–D Click the button above to add this event to your Itinerary Planner... The Best Damned Teaching Case You Have Ever Come Across in Your Specialty Moderator: HENRY APPELMAN Univ of Michigan Hosp Ann Arbor, MI Disclosure: In accordance with ACCME guidelines regarding disclosure, the USCAP policy requires that faculty members who have a significant financial or other relationship with a commercial company, entity, or service (which will be discussed in this Symposium) must disclose this to attendees. The Academy also requires that speakers disclose any products that are not labeled for the use under discussion. The speakers listed below have indicated they have nothing to disclose. Panelists: Laura C. Collins, Beth Israel Deaconess MC, Boston, MA Milton J. Finegold, Texas Children’s Hosp, Houston, TX Wendy L. Frankel, The Ohio State University, Columbus, OH Teri A. Longacre, Stanford University, Stanford, CA Scott Owens, University of Michigan, Ann Arbor, MI Clinical histories are displayed below. For the fastest viewing of virtual slides, click: under each thumbnail image below. You must have Aperio ImageScope installed on your PC. If you do not already have Aperio ImageScope, Windows users with administrator privileges may download and install a free version in order to view USCAP Virtual Slides. Click the icon on the right to get your free copy:   Or, click on slide thumbnail images to view each slide in a Web-based slide viewer, which is somewhat slower. If you have any difficulties viewing these slides, email or call George Clay at +1.724.449.1137. Case 1 Submitted by: Laura C. Collins - Beth Israel Deaconess MC, Boston, MA Clinical Summary: The patient is an 80 year old female with a past history of breast cancer. The specimen is a core needle biopsy, received with the radiologic differential diagnosis of recurrent tumor vs. fat necrosis. Case 1 - Figure 1 Case 1 - Figure 2 Case 1 - Figure 3 Case 2 Submitted by: Milton J. Finegold - Texas Children’s Hosp, Houston, TX Clinical Summary: F.Q. – now 21 yo f 1998 Age 7 – abnormal LFT, high cholesterol 2001- cholecystectomy for stones 2003- ascites – KF rings; liver biopsy; chelation Rx (penicillamine, trientene) Pertinent Laboratory Data: 2005 – AST 85, ALT 80, AlkP 774, Bu 0.4, Bc 0; Pre-Alb 10.3; Serum bile acids x2 = 50; 149; A1AT M1,M3; lipids normal; AFP normal; normal Ceruloplasmin; low serum Cu; elevated 24 hr urine copper; Liver copper content 860 ug/gm; Mutation analysis negative for WD (Mayo) Case 2 - Figure 1 mallory body x500 Case 2 - Figure 2 x50 cirrhosis Case 2 - Figure 3 x100 micronodules Case 2 - Figure 4 x200 lymphocytes, piecemeal necrosis Case 2 - Figure 5 x400 copper Case 3 Submitted by: Wendy L. Frankel - The Ohio State University, Columbus, OH Clinical Summary: 75 year old woman presented in May 2008 with painless, jaundice, pruritus, post-prandial epigastric pain and weight loss over the past month. CT scan showed a 4.9 cm mass in the head of the pancreas that did not extend into the adjacent vessels. She was thought to have a resectable pancreatic adenocarcinoma and was brought to the operating room for a Whipple procedure. After opening the abdomen, she was found to have a single, small subcapsular liver lesion. A frozen section was requested to determine whether the surgeons should proceed with the Whipple procedure or place a stent and abort the procedure. Case 3 - Slide 1 Click to view with ImageScope Click to view with a Web-Based Viewer Case 3 - Figure 1 Case 3 - Figure 2 Case 3 - Figure 3 Case 3 - Figure 4 Case 3 - Figure 5 Case 4 Submitted by: Teri A. Longacre - Stanford University, Stanford, CA Clinical Summary: 54-year-old female with mucinous tumor involving the uterine corpus and cervix Case 4 - Figure 1 Case 4 - Figure 2 Case 4 - Figure 3 Case 4 - Figure 4 Case 4 - Figure 5 Case 4 - Figure 6 Case 4 - Figure 7 Case 4 - Figure 8 Case 5 Submitted by: Scott Owens - University of Michigan, Ann Arbor, MI Clinical Summary: A 62-year-old man presented with perianal pruritis. On physical examination, he was found to have a perianal rash with areas of excoriation and ulcers. There was no other significant medical history and the patient was otherwise healthy. Case 5 - Figure 1 Case 5 - Figure 2 Case 5 - Figure 3 Case 5 - Figure 4 Case 5 - Figure 5 Case 5 - Figure 6 CEA Handouts for all Specialty Conferences will be accessible via the "Educational Materials" section on the homepage the morning after each respective conference. Printed copies of the handout will not be available at the meeting.